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  • Morning Bell: Doc Fix Digs Debt Deeper

    Yesterday at 3:00 p.m. ET, the Treasury Department updated its calculation of the U.S. National Debt to: $12,031,299,186,290.07. That $12 trillion record high comes just eight months after it hit $11 trillion and is only expected to rise faster considering the federal deficit for 2009 was over $1.4 trillion. And what is the leftist majority of Congress going to do tomorrow about these skyrocketing deficits? They are going to pile on the spending faster.

    The issue at hand is the congressionally created formula for annually updating the payments doctors receive for treating Medicare patients. The centrally planned price fixing formula was designed to control health care costs by tying doctor payments to the overall growth rate of the economy. Problem is the realities of supply and demand in the health care sector have pushed doctor’s fees higher than the formula allows for. So instead of going back and fixing the formula (or heaven forbid introducing some market based reforms into Medicare), every year Congress passes short-term fixes rescinding the scheduled rate cuts.

    Fixing the problem permanently has long been the top legislative priority for the American Medical Association, and in exchange for their endorsement of Obamacare, Speaker Nancy Pelosi (D-CA) promised them she would do so. Problem is Pelosi and co. could not figure out how to game the Congressional Budget Office’s numbers to show that Obamacare was deficit neutral and pay for the so called “doc fix” at the same time. So they solved the problem by pretending the “doc fix” was not health care reform. But to keep the AMA happy they took the unusual step of combining the debate rules for Obamacare and the doc fix.

    As a result, Congress is set to debate the bill tomorrow for just one hour, and no amendments will be allowed. In other words, even if conservative Democrats or Republicans wanted to propose an amendment that would pay for the doctor’s higher payments, they are prevented from doing so. According to the CBO, just the ten year cost of the legislation will be $210 billion, but the damage does not end there. Medicare is a never ending entitlement program, so the real pain caused by the left’s free spending will be felt for decades to come. According to the latest report from the Medicare Trustees, the 75-year cost of allowing doctor payments to match the percentage change in the medical economic index is $1.9 trillion in more debt.

    Americans who are concerned about our nation’s exploding deficits under President Obama and the leftist majorities in Congress should keep the doc fix debacle in mind when considering Obamacare. The deficit neutrality of the House-passed Obamacare bill entirely depends on Congress’ ability to cut $500 billion from hospital Medicare payments over the next ten years. Does anyone believe those cuts will ever happen?

    Quick Hits:

    • The Dean of Harvard Medical School writes in the Wall Street Journal: “The various bills do deal with access by expanding Medicaid and mandating subsidized insurance at substantial cost—and thus addresses an important social goal. However, there are no provisions to substantively control the growth of costs or raise the quality of care. So the overall effort will fail to qualify as reform.”
    • In a sign of weakening political will, Senate Democratic leaders said Tuesday they would put off debate on a big climate-change bill until spring.
    • President Obama directly acknowledged for the first time Wednesday that the prison facility at Guantanamo Bay will not close by the January deadline he set.
    • Data released by the Federal Reserve, the National Association of Homebuilders, and the Labor Department Tuesday shows the economic recovery continues to be weak.
    • The chairman of the Obama administration’s Recovery Board admitted to Rep. Darrell Issa (R-CA) yesterday that he can not certify that that the number of jobs reported as created/saved on Recovery.gov is accurate.
    Posted in Ongoing Priorities [slideshow_deploy]

    37 Responses to Morning Bell: Doc Fix Digs Debt Deeper

    1. Allen, Alabama says:

      We still have a few good people in Washington, but they can't get anything done for all of the negotiating going on by the people up there that don't care. History shows that when you raise taxes you have less to come in and less to run the country on. When President Bush got the tax break to go through our country had more money coming in than it had ever had and was really getting rid of the deficit that had been built up over the previous 8 years of administration. Then 9/11 happened and we had to change gears in order to protect the American soil. If we had not taken the war to Iraq and Afganistan there would have been even more attacks on America. As far as the mess laid at our current adminstrations feet, the responsibility lies on the Democrats shoulders. The had control of Congress the last two years of President Bushs Presidency and did all they could to try to ruin America. They did a really good job. If America doesn't wake up and vote out these people in the next two elections there will not be an America left for our Children and Grandchildren. The Economy is already almost to the point of NO RETURN. As far as Pelosi goes, look at what American taxpayers are paying per month for her to commute to Washington and home.

    2. Jonathan Seid, Willi says:

      When the deficit crushes the American taxpayer and inflation is riding hard with spurs on the back of each citizen, there will be calls for reform and austerity.

      Will government programs be pared and will the amount of spending be reduced then? No. It will not.

      What will happen is the rate of growth will be reduced and that will be called "a spending cut". We will be an angry audience watching this political drama and it will stink. We will demand our money back. But it will have been spent and all we will have is a promise from thieves who should be rounded up and put in jail.

    3. Doug Warner, Cabot, says:

      This is a great article with information that all should know. However, it leaves out one point. There are two goals of this administration and they are not medical related.

      One, Obama wants in the end to have a single payer system. He wants it not so that he will control, or the government will control the medical insurance, but so that more money will flow into Washington so it can be wasted on other programs and handed to special interests, like Medicare.

      Two, this is an arm of his radical liberal plan to grab as much governmental power as he can. Power and money makes a huge government. When you include medical care, the people become dependent on the government and can't fight the growth of government. Obama isn't hudging up to Hugo Chavez and Vlad Putin and he isn't walking on egg shells around Ahmadinejad and Kim Jung Il for no reason, he likes their style of leadership and intends to make this country just like theirs.

      To Obama, this health care issue about taking care of people, it is about growing government. If he really cared about making a health care system that worked for everyone and did everything to reduce costs, the issues of TORT reform, Pharma reform, portability and others would be directly addressed and both parties would be at the table negotiating this bill. He would realize that this being about 1/6th of our nations economy is much to big and much to important to politicize. He instead has chosen to use this to grow government and spend trillions on growning government. But, America, you voted for him…now you will suffer because of him.

    4. Jeanne Stotler, Wood says:

      This administration delves in fuzzy math. When I went to school we were told 2+2=4, today we are told 1+2=5, they believe all of us are stupid, not just dumb, but STUPID. They are the most corrupt Congress ever, my own REp. defied all the constituents and voted for this monstrous health bill, he even sent me a letter saying he agreed with this when I said I didnot agree with it, what arragance.

    5. Rita, Augusta, GA says:

      It is becoming more and more difficult to avoid developing conspiracy theories with the current administration, as I wonder what the motive could possibly be for the actions they take on may fronts especially as they spend us into oblivion.

    6. Dub from Celina, Tex says:

      How much is Obuma paying ARRP to endorse this obumacare health package? I am amazed to see senior citizens not voicing a negative reaction to these Reid and Pelosi health proposals that will destroy our ability to choose our Doctors and maintain our current health coverages. Since we are forced into Medicare, are we now going to be forced into a government run system that will be dictated by non'informed folks what treatments, etc. will be performed without government approval. Our personal Doctors should be the final judge in any treatments or studies.

    7. Tim H. Carrollton,Ga says:

      Has anyone that follws this website or in this country thought about,what will happen if our country goes bankrupt? Has anyone really pondered in their mind what could happen? People had better stop being Republican or Democrat and just start thinking about America! I wonder if people thinks it could NEVER happen? Do they think that Washington will just have a magic trick to pull out of a bag? Americans better wake up and think like Americans-not Republican/Democrat!God Help US

    8. Lisa Saunders, MD, N says:

      Before you blame doctors' fees for the high cost of health care, shop around for an MRI or a CT scan, or pay for your own prescriptions or physical therapy, like I do. I am against Obamacare, and am against further medicare rate cuts to doctors.

      As an Anesthesiologist, medicare pays me only 30% of what it costs to make a living. For primary care, medicare pays 80%. If the public option rates are tied to medicare, you will be hard-pressed to find an MD anethesiologist, as the private insurance rates will surely follow downward. It is easier to see why the AMA supports it, as it has bonuses built-in for primary care providers, which they deserve.

      Every year, medicare has planned 10% rate cuts to anesthesiologists, which our society has thus managed, year after year to fight tooth and nail to stave off.

      Medicare payment to physician anesthesiologists and nurse anesthetists is the same, has been for many years. It seems the government does not see added value in physician-provided care, nor it seems does society. People think nothing of shelling out hundreds of dollars for sporting events and entertainment, yet health care costs are breaking them.

      Go figure.

    9. Blair Franconia, NH says:

      There's an old saying that goes as follows: "When you're in a hole, stop digging." Remember last year when the Democrats,

      including their standard bearer, MMM, MMM, MMM BARACK HUSSEIN OBAMA! were on Bush's case for allowing the deficit to go to $5 trillion? Well, Obama just increased it another $7 trillion. Remember when Reagan and George H.W. Bush were

      President? The deficit back then was ONLY IN THE BILLIONS!

      We'll need a Republican Congress and a Republican President to clean up the mess that Obama and his Democratic cronies are leaving our children, who'd better learn to speak Mandarin Chinese, because we'll be annexed by the People's Republic of China. It's easy. All you have to do is say "Ni-hao!" and kotow.

    10. Nathan - near Roches says:

      Reagan said something to the effect of "politicians, always with the best intentions, say 'with just a little more power, a little more money, we can fix this…' But we know that it doenst work out like that".

      The bottom line is, neither we nor the government can grow money on trees to pay for what we'd like, simply because its ideal. "Ideal" is not the way the world works, and the only way to create that 100% of the time is via coersion. When those of us with the money and/or expertise decide we've had enough of the BS political games, the only way for government to continue its power grabbing ways is through force.

      We must stop that from happening well in advance.

    11. Jack E Lohman says:

      Folks, understand what causes taxes and put a stop to it, or quit complaining.

      Special interests pay for government spending through campaign contributions, and that causes taxes to increase. Only public funding of campaigns will stop it, and at $5 per taxpayer per year it would be one hell of a bargain.


      See: http://www.fairelectionsnow.org

    12. LeRoy Reed says:

      This all must STOP NOW!!!!!! Help is needed!!!!

    13. Dennis A. Social Cir says:

      The dems are runing us into more debt than we can handle. They are told and shown this but pay no heed to the facts. They as pelosi says "won" so what ever they want to do is just fine. The American people have no say in what happens to this country or to us. This time around the carter error will seem like playtime, inflation and a weak dollar stands a good chance of seeing this country go under.

      Will we allow this country to go belly up, or will we as citizens start paying attention to what is happening and stand up to bring this farst to a stop? People it is past time to stop the hand outs to many and began to creat jobs, lower taxes and get this country going again. We can do it, all it takes is going to the polls and vote in 2010, put the dems out in the street before it is to late for us, our children and grand children.

    14. Bonnie, Michigan says:

      Pelosi appearing on PBS in October stated that it is fair to look at a Value Added Tax to pay for all of this spending. My solution….stop spending. This Administration is ruining our Country. Rise up Americans and call Congress until you know them by the sound of their voices. Our voices are all we have until 2010 then "Vote the Traitors Out"

    15. W. Jeff Terry, MD says:

      HR 3961 is not a "doc fix"! It is a

      "Seniors' Care Fix"! Please don't forget this is all about keeping access to care for our seniors. Our country has made a commitment through Medicare to take care of our seniors and this commitment needs to be kept before moving on to a multi-trillion dollar government controlled new health care reform program.

    16. sherry - massachuset says:

      What rock did these people in congress crawl out of. We should take them all and dump them on an island in the middle of the ocean surrounded by sharks. They know exactly what sharks are. Lets take our country back and lets do it like our forefathers did. This is my country, they work for me not the other way around. Our country is headed for a revolution, watch out, we will win.

    17. Pingback: 12 Trillion dollar debt « 2tts Blog

    18. Roger Haley, Visalia says:

      While hating the thought of worsening deficits, I do have to comment on the implication of the article that physcian "fees" are just going up and up.

      The "fix" is intended to correct a widely acknowledge flaw in the Clinton Era balanced budget act calculation for physician fees: The SGR (sustainable growth rate) calculation incorporated into "physician fees" the cost of certain drugs given in the physcian office. These drugs are generally newer (read: expensive), save enormous amounts of money compared with what administration in a hospital infusion center setting would cost, and are remibursed to physicians right at or even below cost. Since the drugs are very helpful to our patients, cheaper for our patients, and since there is a small "adminitration" fee, we give them in the office, without losing money.

      The costs are rolled in and considered "physician fees" for purposes of the SGR.

      The thrust of the AMA (and I completely disagree with their support of the "Health Sytem Reform") is to PREVENT a 25% REDUCTION in our true fees, which would go into effect in 2010 barring congressional action.

      Try to run ANY business on a sudden 25% reduction in reimbursement (with the SAME overhead). Failure to just keep us even (my overhead has not dropped, ever) would be devastating to my heavily Medicare based practice.

    19. Pingback: Corruption Gets Deeper on Capitol Hill | Defense of the Republic

    20. Richard Cancemi, Arl says:

      That whole bunch of liberal Marxists make me sick! And those that follow along like the rats that followed the Pied Piper make me even more sick! They seem to NOT realize that they too are going to be raped by this despotic clique.

      When are the American people going to rise and put a stop to all this tyranny?

      Do we have ANY advocates for the Constitution and American Capitalism among our Representatives? To date they have been sniveling whiners!

      Are we without American leaders of courage? Are there no more American heroes?

    21. Mark Malley, MD, DAB says:

      I don't know what is in this bill, but your blog misstates the facts about the dr. fix. We did not get more money per exam with the fixes for the last few years. More exams have been performed because of increased numbers of exams. The formula demands no increase in total payments to doctors. The fixes just allow us to get paid for what we do, not increase our payments. If you saw more patients, you should get paid more; you should not be penalized because you had more demands placed on you or you worked harder. The problem is we promise care, but we don't want to pay for it. Doctors are not the problem and shouldn't be penalized.

    22. Wallyblu, Zion, IL says:

      The whole system will come down like a house of cards when those getting entitlements outnumber those paying the costs.

      All the libersls in big cities better start finding places to grow their own food because I'm not going to share.

    23. Prevailer76AZ says:

      It seems to me the sole purpose of the barrage of frenzied activity in Congress at the behest of our President is to create chaos. We are at the mercy of mixed messages from the President to the Atty General. Nothing makes sense. Diversionary tactics are nothing new, and we must be aware that neither are lies.

    24. Pingback: President thinks you are dumber than dirt « GOODNESS WORLD LIFE BLOG

    25. Michael R Michaelson says:

      No one wants to address unnecessary medical spending. Here is both an example and solution that could save hundreds of billions, improve quality of life issues, and improve overall health.

      In 2008 the heart health (cardiovascular repair) industry collected $448.5 Billion due to a simple misdiagnosis of the cause and cure. I'll explain.

      Nearly all cardio problems are the result of chronic scurvy due to insufficient vitamin C, aka ascorbic acid. Evolution took away the capacity of primates, guinea pigs, fruit bats, and man to create vitamin C within the liver. These species got their start in locations that had significant, vitamin C-producing fruits and veggies. So, evolution turned off the vitamin C switch in the liver (the switch still remains).

      Then man went to the far reaches, into cold climates, and vitamin C was not plentiful in the food supply. The scourge of acute scurvy (bleeding into the body from blood vessels resulting in death) appeared and evolution stepped in again. This time evolution modified the repair system to include a variation of the LDL cholesterol system, sub-set Lp(a), into a repair mechanism.

      In the face of certain death, evolution selected to evade death of the organism by designing a temporary plug. Lp(a) attaches to lysine and proline (rope-like strands within the arterial wall) to block the bleeding of the artery through the wall into the body. The Lp(a) makes a plug and then collects the -C faction of LDL to make a patch over the area. The longer the deficiency exists, the more debilitation will occur; ergo, the more plaque will spread along the arterial wall, i.e., the cholesterol "smear" of the arterial wall as shown in the Crestor and Lipitor educational advertisements.

      The Framingham Study apparently found the involvement of LDL-C, but ignored the Linus Pauling/Mattias Rath study (query Linus Pauling) of the 1980's (and their subsequent US patent). Pauling/Rath determined the role of Lp(a) as the evolutionary stop-gap to death from acute scurvy. With that determination, the "cure" was simply to elevate vitamin C intake to about 2 – 4 grams per day to prevent atheriosclerorsis, stroke, and several other nutritional and immuno deficiencies. (As an aside, Linus Pauling, PhD, was awarded a Nobel Chemistry prize (1952) for his work in molecular biology, as well as the Nobel Peace prize (1962) for his efforts for world peace. Pauling is the only double winner who does not share the award with others.)

      In the United States the current recommended daily vitamin C intake (RDI or RDA under earlier guidelines) for men is 90 mg, far lower than what would be ingested naturally in a produce-rich, tropical setting. Under the 90 mg standard, ACUTE scurvy is prevented. However, CHRONIC scurvy will silently occur.

      Statin drugs were designed to decrease the amount of cholesterol produced by the liver, under the premise that a shotgun will hit all the offenders and that would be enough. While cholesterol will be impacted by statins, no medication is capable of reducing production of Lp(a). So, the statin bullets are ineffective. But the side effects of statins include damaged immune system, sex hormone issues (can you say Erectile Dysfunction!), ALS, Alzheimer's Disease, Transcient Global Amnesia and all things in between.

      Both Lipitor (statin) and Viaga are produced by the same company, in a masterpiece of working both sides of the street for maximum income: Lipitor stifles sexual response and Viagra invigorates the response.

      In Slovakia (query Google, "ginter vitamin c" for 8400 entries) the public health department went about changing public attitudes about some elemental steps that could be made to reduce the death rate, beginning in the 1960's. They recommended using butter instead of vegetable oils (free radical damage to blood vessels), maintain a healthier life style by including diet and exercise, stop smoking, and add supplemental vitamin C daily. In short, they advocated doing the reverse of what was then current thinking in the AMA (and continue to do so) with the result of a vast decrease in the death rate and improvement of overall health. In the meanwhile, the AMA experience reflects an continued, spiraling increase in cardiovascular disease and stroke.

      For myself, beginning in 1983 I have experienced cholesterol and cardiovascular disease and treatment. Until I recently took myself off Lipitor in September 2009, my yearly cost for that medication was $1400 per year, times 26 years, means my insurer was on the hook for $36,400 just for one pill. Of course, the treatment (diet and exercise) failed to impact the scurvy, so a blockage was found. So, we did an angiogram to determine the extent of the problem, found reason to do an angioplasty, but then went an additional step to install a bare metal stent (BMS) in the problem area, all completed in July 1999. The BMS became blocked (restenosis) and required another angioplasty-like procedure to roto-rooter the blockage in November 1999. The next blockage happened more quickly than before, and the treatment this time was a bypass in March 2000 (LIMA to LAD). Throughout, my cardiologist only knew that sometimes "infections" or "inflammations" happen. So, the cost of continued treatment for my problem is somewhere above $100,000 and no "cure" has happened.

      Basically, I found the cure on Google. Just query "vitamin C deficiency" or "statin damage" and you'll get started. The AMA doesn't tell the doctors about vitamin C and Merck certainly won't!

      Every human on the face of the earth needs more vitamin C than what they are getting, in proportion to their size and age. Seniors can avoid strokes just by taking 2 – 4 grams of vitamin C daily. Hey, Costco sells vitamin C for $15 for 500, 1000 mg pills, at 2 – 4 pills per day…. Sounds like a bargain to avoid stroke or bypass surgery.

      BigPharma is interested in the Codex International becoming part of our way of life. BigPharma wants to control the over-the-counter stuff in the name of "purity" and such. When vitamin C is a money maker, Merck will restrict over-the-counter access, start selling it at a vast profit and advertising the benefits as a "new" discovery.

      Query "Frederick R. Klenner, M.D." on Google. He used vitamin C in general practice for years and cured so many diseases that you wouldn't believe it without reading it for yourself.

      Today, we learned that "niaspan" (a BigPharma product based on niacin) can reduce cholesterol at a lower cost than statins. The impact of niacin (and niacinamide) on total cholesterol was known in the 1960's, but the AMA didn't support that conclusion. Niacin is an over-the-counter drug, for pennies a pill.

      While some heart issues are part of life, most of the $448 Billion is for the mis-diagnosis of cholesterol related issues, curable by vitamin C. Most of the money goes to fighting cholesterol (which the body needs/produces its own in the absence of dietary cholesterol) and fixing arterial plumbing issues without addressing the issue of scurvy.

      Who better than Heritage to raise the issue.

      Who in your life should NOT have access to this information? Who in your life do you WANT to have a heart attack or stroke?



    26. Tony, Australia says:

      Can anyone explain to me what proportion of this deficit can be attributed to the Iraq War?

    27. jim toledo says:

      Hope and change you can believe in, right. It's hard to believe that we would be forced to sit on the sidelines and literally watch the dismantling of our rights, our freedoms and our economy. What is happeing today is really sad; we can make a decision in Afgahistan, our troops are in harms way, Iran is thumbing it's nose at us and will have a nuke soon, our unemployment rate is somewhere between 10 -17%, our debt is over 12 Trillion and we've spent over a trillion dollars just in the past year, banks are still failing, we bailed out the Automotive industry and they are still struggling, we are on the verge of trying terrorists in as criminals in court giving them our rights and we're still trying to pass a monster bill on healthcare that nobody really wants. Isn't it a great thing to be a Democrat and stand for the dismantling of our counrty.

    28. Pingback: The Wall Street Journal: $1.9 Trillion Gimmick | Fix Health Care Policy

    29. Patriot Cat, Texas says:

      Isn't a liberal Marxist an oxymoron? Anyway, the ruin of the currency is what the Saudis want…China owns us…I can't believe that people think that Obama gives a flip about anyone..as for 'senior', he's already on record for "isn't there a pill for that?" The gov't saying that women don't need mammograms, etc…that's just preparatory to the healthcare bill that Reid is so giggly about…is anyone awake out there? Why haven't the "talking heads"mentioned the fines and imprisonment awaiting us for not having insurance…and you do realize that the IRS is being given permission to "electronically" take this money from your personal bank accounts!!! What is wrong with this group? Do they really think that people understand "deficit spending?" No, they don't…but they do understand going to jail, being taxed for using too much energy, collection of funds from private accounts, permission to have children, and they also understand that MSK is not an American and has no rights under our Constitution…what does Holder and the rest of those maggots think we are…ignorant? Oh,yes, I forgot.He called us ignorant in Congress today, didn't he?

    30. John, Colorado says:

      Obama and the people behind him are truly smarter than credited. Not only do they do stimulus spending knowing full well it won't work, they make sure the money does not get spent in such a manner as to even have a chance of causing any positive stimulation of the economy. And instead probably are stuffing the mattresses of criminals all over the country and strengthening the power and network of the global elite.

    31. t kulcsar says:

      I was wondering if Obama and his gang is planing on giving up their pay for the rest of their lives to help pay for this mess they're putting AMERICA in?

    32. Bill Witter, San Ant says:

      I take issue with your statement that Medicare is an entitlement. Medicare and Social Security are paid programs which I have been paying on for years, and continue to pay for Medicare to the tune of $96.40 per month. I cannot help it if our government has, over these same years, raided the funds and left nothing but IOU's.

      We need to change the government, not Social Security or Medicare.


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